The author is a Forbes contributor. The opinions expressed are those of the writer.

Loading ...

Loading ...

This story appears in the {{article.article.magazine.pretty_date}} issue of {{article.article.magazine.pubName}}. Subscribe

Many American conservatives oppose universal health insurance because they see it as fundamentally antithetical to a free society. “If we persevere in our quixotic quest for a fetishized medical equality we will sacrifice personal freedom as its price,” wrote a guest editorialist in the ]Wall Street Journal in 2009. But according to the Heritage Foundation, a leading conservative think tank, ten nations freer than the United States have achieved universal health coverage. It turns out that the right kind of health reform could cover more Americans while increasing economic freedom.

Today, Heritage published its 2015 Index of Economic Freedom, an annual look at economic liberty around the world. The United States stayed put at #12, just below Ireland, Mauritius, and Denmark.

What’s striking about the list is that of the eleven countries ahead of the U.S. in economic freedom, ten have achieved universal coverage. Many Americans on both the right on the left subscribe to the myth that the U.S. has a free-market health care system. It doesn’t. U.S. government entities spend more per-capita on health care than all but two other countries in the world.

The Swiss and Singaporean models

The two advanced economies with the most economically free health care systems—Switzerland and Singapore—have achieved universal health insurance while spending a fraction of what the U.S. spends. Switzerland’s public spending on health care is about half of America’s, and Singapore’s is about a fifth of ours. If we had either of those systems, we wouldn’t have a federal budget deficit.

Tellingly, on the Heritage Index of Economic Freedom, both Switzerland (#5) and Singapore (#2) rank far higher than the U.S. on overall economic freedom. Both countries serve as models for my health reform plan, Transcending Obamacare, which would adapt features of the Swiss and Singaporean health care systems to liberate U.S. health care from onerous regulations and wasteful spending. We’ve modeled the plan as reducing federal spending by $10.5 trillion over 30 years, while increasing the number of people with health insurance by 12 million.

Not all nations ranking higher than the U.S. for overall economic freedom have exemplary health care systems. Canada (#6) has a government-run, single-payer health insurance system with long wait times, restricted access to the latest technology, and fiscal challenges. But imagine how much freer Canada is in other economic spheres, given that it ranks so much higher the U.S. despite government-run health care.

Conservatives have succumbed to the left’s view of health care

Here’s something you hear a lot in conservative circles: “We’ll never outbid the left when it comes to covering more people, so we shouldn’t even try.” Philip Klein makes this argument in his new e-book, Overcoming Obamacare, in which he argues that “supporting Roy’s proposal would be a huge leap for limited government conservatives” because they would “be expected to embrace the goal of universal coverage.” Conservatives like Klein have accepted the left’s framing of health care: that the only way to cover more people is to expand the scope and scale of government.

Think about that for a second. Would you ever hear a conservative say “We’ll never outbid the left on job growth, so we shouldn’t even try?” Or “We’ll never outbid the left on education reform, so we shouldn’t even try?” Or “We’ll never outbid the left on the number of Americans with smartphones, so we shouldn’t even try?”

Of course not. In each of those instances, the advocate of free markets would say: “Economic freedom will lead to more job growth, better schools, and technological innovation.” So why is it that conservatives have accepted that the only way to expand access to health care is through more government?

It’s bollocks. The reason why U.S. government health care is so big already, without achieving universal coverage, is that we heavily subsidize health coverage for Americans with high incomes, while leaving many Americans with low incomes unsubsidized. If we had a true safety net, in which we helped the poor and sick get coverage—while letting the wealthy buy health care in the free market—we’d spend a fraction of what we do today.

These are the lessons driven home today by the Heritage Foundation’s annual rankings. They’re lessons that conservatives ought to consider.